Pelican HSA Plan Reminder

As a reminder, employees selecting the Pelican HSA 775 Health Insurance Plan are to complete the Health Savings Account Enrollment and Payroll Deduction/Change Form each calendar year.  If the form is not completed, a Health Savings Account will not be opened and the employer contribution of $200 will not be provided.  An employee who elects to change his/her monthly deduction must also complete a new form.

Thanks,
Vickie

Vickie S. Desormeaux
Benefits Specialist
Human Resources Department
University of Louisiana at Lafayette
Post Office Box 40196
104 University Circle, Martin Hall, Room 170
Lafayette, Louisiana   70504
(337) 482-1014 - phone
(337) 482-1452 - fax
www.louisiana.edu